This applicant requests a Mentored Clinical Scientist Development Award to identify the influence of family factors on the course of borderline personality disorder (BPD) and its treatment in the community. A five year program of research and education will furnish the principal investigator with the multifaceted skills and expertise needed to completed state-of-the-art research with this segment of the persistently mentally ill and their relatives. BPD patients are not only challenging and expensive to treat but are also the largest growing subset of psychiatric patients with persistent illnesses. Although the role that the family environment plays in the genesis of the disorder plays in the course and effective treatment of the disorder. The absence of this critical information severely limits the range of potential treatment strategies that are crucial to the recovery process. The research component has two studies. The first study will collect data to test the hypothesis that certain family patterns and attributes (e.g., the absence of parental pathology, high emotional involvement, low perception of burden, high patient validation, effective familial problem-solving, low negative affective style, knowledge about the disorder) will predict one-year patient outcome as measured by: 1) frequency and severity of suicidal behaviors; 2) number of re- hospitalizations; 3) behaviors that limit the quality of life, including: a) depression, b) alienation in family relationships, c) generalized hopelessness, d) level of loneliness; and 4) reasons for living. The second study is to conduct a pilot study on a family intervention as an additional treatment to standard Dialectical Behavior Therapy. The "add-on" intervention will be pilot tested in a controlled study targeting the variables that are shown to be documented as influential, prevalent, and modifiable in the long-term course of the disorder.